Objective To compare the clinical efficacy of minimally invasive percutaneous pedicle screw fixation and posterior paraspinal muscle space approach pedicle screw fixation for the treatment of thoracolumbar fractures.Methods Retrospectively analyzed the clinical data of 29 patients treated via minimally invasive percutaneous pedicle screw fixation(minimally invasive group) and 28 patients treated via posterior paraspinal muscle space approach pedicle screw fixation(paraspinal muscle approach group) from March 2013 to October 2015.The anterior vertebral height ratio,sagittal Cobb angle,surgical incision,operation time,number of fluoroscopy,intraoperative blood loss and ODI and VAS scores were compared between the two groups.Results All patients were followed up for an average period of 12.6 months (ranged from 6 to 18 months).At the end of 3 days,3 months and 12 months after operation,vertebral sagittal index and Cobb angle of the two groups were significantly recovered compared with the preoperative data(P<0.05),and the ODI and VAS scores were significantly lower than those before the operation,but the above indicators had no significant difference between the two groups(P>0.05).The surgical trauma and intraoperative blood loss of patients in the minimally invasive group were significantly lower than those of the paraspinal muscle approach group,while the operation time and fluoroscopy times were significantly higher than those of the paraspinal muscle approach group,and the differences were statistically significant(P<0.05).Conclusion Minimally invasive percutaneous and paraspinal muscle approach pedicle screw fixation are both effective,safe and reliable.Paraspinal muscle approach pedicle screw fixation has shorter operation time and easier operation,while minimally invasive percutaneous pedicle screw fixation has less trauma,less bleeding and faster postoperative recovery.

Purpose Brain complications severely threaten the treatment and survival of children with leukemia. This paper aims to investigate the MRI manifestations and differences of brain complications in leukemia before and after chemotherapy for a clinical guidance.Materials and Methods The clinical data and MRI findings of 37 children with leukemia and brain complications were retrospectively analyzed. Thirty-four of them underwent MRI scan twice or more, among whom 28 received contrast-enhanced MRI scan.Results Twenty-two patients were discovered with brain complications before chemotherapy, 2 of whom were with two kinds of complications. Meningopathy was found in 7 patients who showed widespread or localized meningeal thickening. Among them, 5 patients'' lesions reduced or disappeared after chemotherapy. Intracerebral multiple small and micro bleed was found in these 7 patients, 2 of them combined with hematoma. Three patients were found with intracranial tumor which all proved to be temporal bone tumor, 1 of whom combined with temporal lobe tumor and 1 had tumor disappeared after chemotherapy. The other complications before chemotherapy included leukoencephalopathy (n=2), subdural collection of fluid (n=2), meninges and parenchymal infiltration of leukemia (n=1), fungal infection (n=1) and cerebral infarction (n=1). On the contrary, 17 patients were discovered with brain complications after chemotherapy, 8 of whom were with two or more complications. Two patients had different kinds of complications before and after chemotherapy. Brain atrophy was observed in 13 patients. Leukoenphalopathy was found in 9 patients who presented high signal in white matter of double periventricular and/or semi-oval center on T2WI; the lesions of 4 patients were reduced or disappeared after withdrawal. Infectious diseases were diagnosed in 3 patients, including viral encephalitis in 2 cases, tuberculous meningitis combined with tuberculoma in 1 case. The other complications included intracranial tumor (n=2), sinus thrombosis (n=1), posterior reversible encephalopathy syndrome (n=1) after chemotherapy. Conclusion The MRI findings of brain complications in childhood leukemia are various and demonstrate significantly different features before and after chemotherapy. The major complications before treatment include meningopathy and intra-cerebral hemorrhage;while after chemotherapy the main complications are brain atrophy, leukoencephalopathy and infectious diseases. MRI proves to be a valuable method to detect, observe and follow up these complications.

Objective To evaluate the arc renal parenchyma incision of pelvis within renal sinus and renal posterior lib for the removal of complex staghorn renal calculi.Methods Arc renal parenchyma incision of pelvis within renal sinus and renal posterior lib was performed to remove stones in 86 cases (97 sides) with complex staghorn renal calculi.Among the 86 cases,42 had stones on the right side;33,on the left side;11,on bilateral sides.Seventeen cases had concomitantly calculi in the ureter,and 54 had calculi in upper and mid calyx or multiple renal calculi.As for comorbidity,11 cases had hypertensions;4,diabetes; and 5,hepatitis B.Twenty-five cases had renal insufficiency,with BUN of 12.3 -76.0mmol/L and Cr of 231 -1721?mol/L.The procedure was performed as follows:the kidney was dissected free and the pelvis within renal sinus was isolated.Two rows of bottom style sutures were made on the renal parenchyma with 2-0 plain catgut along mid-lower 1/3 of the dorsal surface of kidney free of vessels from the renal posterior lib to the plane of lower major calyx.The renal parenchyma was opened.Then,the incision was developed from the plane of lower through the middle major calyx to the plane of upper major calyx.The renal parenchyma and mid-low calyx along the incision were opened,suturing while incising,so that all the stones could be easily removed with hook.Results The calculi were completely removed in all 86 cases (97 sides).The opera- tive time was 105-187min ( mean,129min).The intraoperative blood loss was 120-460 ml ( mean,220 ml).Forty-three cases needed intraoperative blood transfusion of 120 -200 ml (mean,140 ml).One month after operation,KUB+IVU and ultrasonic findings were normal with improved hydronephrosis,no intrarenal stricture and no residual calculi.Conclusions This procedure has the advantages of less bleeding,slight impairment of renal function,simple handling,clear operative field,high clearance rate,therefore is indica- ted for the removal of complex staghorn calculi.

Objective To study the feasibility of interventional pulmonary lobectomy by animal experiment. Methods Twelve healthy dogs were divided into three groups randomly,with 4 in each. Group A: the target bronchus and alveoli were filled with emulsion of lapiodal and alveolar cells damage liquors and then the target bronchus was occluded with Polymethylmethacrylate(PMMA). Group B: The target bronchus was only occluded with PMMA. Group C: Pulmonary lobe was resected surgically. Arterial blood gases were measured at the time of pre-procedure and post-procedure and then 1st, 2nd, 3rd and 4th week after the procedure respectively. Chest radiography histology and bacterial culture of tissue of target lung lobe were made after 4 weeks. Results There was a significant difference in arterial blood-gas among 3 groups pre-procedure in comparion with those of post-proceduce immediately (P0.05) in comparing with 1st, 2nd, 3rd and 4th week after the procedure. Atelectasis was shown radiologically with histological formation of fibrosis of target lung lobe but no bacteria grew in target tissue 4th week after the procedure. There were two cases of lung atelectasis but no pulmonary fibrosis occluded in group B. Conclusions Interventional pulmonary lobectomy might be obtained after the target bronchus and pulmonasy alveoli were filled with emulsion of dipiodal and alveolar cells damage liquors and then the target bronchus was occluded with PMMA.

Objective To explore the difference of gene expression profiling between normal basilar arteries and basilar arteries of cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH) in rabbits. Methods cDNA chip of normal basilar arteries and basilar arteries of CVS after SAH in rabbits were downloaded from GEO database. The chip was analyzed and screened by Bioconductor software, and function enrichment and pathway analysis of the differentially expressed genes were analyzed by Cytoscape software. Then 6 adult male Japanese rabbits were used, and randomly divided into normal control group (n=3) and SAH model group (n=3). Rabbit SAH models were established by cisterna secondary-blood-injection method. RNA data of normal basilar artery specimens on the 0 day and basilar artery specimens after SAH on the 5-day were used to validate the parts of differentially expressed genes by qRT-PCR. Results A total of 4356 differentially expressed genes were found in normal basilar arteries and basilar arteries of CVS after SAH in rabbits. Among them, 920 genes were considered to be significant with P-value<0.05, such as GRIK1, MYH13, ZNF45, SAA3, RLN1, MSR1 and others. Function enrichment analysis indicated that the differentially expressed genes were involved in regulation of Ca2+transmembrane transporter activity, negative regulation of ion transmembrane transport, regulation of potassium ion transport, positive regulation of JAK-STAT signaling cascades and other biological processes. Pathway analysis showed that calcium signaling pathway, cGMP-PKG signaling pathway, HIF-1 signaling pathway, PI3K-Akt signaling pathway and other signaling pathways maybe related with the differentially expressed genes. qRT-PCR verification showed that the expression of MSR1 in SAH model group was consistent with that of the chip result. Conclusion The gene expressions of basilar arteries of CVS after SAH in rabbits are significantly different, and MSR1 gene can be used as a potential target for studying the pathological mechanism of CVS.

BACKGROUND:The repair method of proximal humeral comminuted fractures in the elderly remains controversial. OBJECTIVE:To compare the recovery of shoulder joint function using the hemiarthroplasty of shoulder and locking proximal humeral plate fixation for complex proximal humeral fracture in the elderly. METHODS:A total of 22 elderly patients with complex proximal humeral fracture, who were treated from October 2012 to October 2014, were retrospectively analyzed. 12 cases underwent hemiarthroplasty, and 10 cases received locking proximal humeral plate fixation. Al patients were folowed up after treatment. X-ray films were rechecked during the folow-up. The recovery of shoulder function was evaluated with Neer score. RESULTS AND CONCLUSION:During final folow-up, no prosthetic loosening or avascular necrosis of humeral head was found in the shoulder hemiarthroplasty group, and the Neer score was (81±5) points. In the locking proximal humeral plate fixation group, there was fixator loosening in four cases and avascular necrosis of humeral head in three cases, and the Neer score was (69±5) points (P < 0.05). During repair, mean operation time was shorter in the shoulder hemiarthroplasty group than in the locking proximal humeral plate fixation group. The amount of bleeding was higher in the shoulder hemiarthroplasty group than in the locking proximal humeral plate fixation group (P > 0.05). These data suggest that locking proximal humeral plate fixation and shoulder hemiarthroplasty are effective repair methods for complex proximal humerus fractures, but the hemiarthroplasty had the advantage of early functional exercise and good recovery of shoulder joint.

With the continuous development of musculoskeletal ultrasound,ultrasound diagnosis of inflammatory arthri tis,especially early diagnosis had an increasing important role.Psoriatic arthritis (PsA) was a kind of inflammatory arthritis,which was closely related with psoriasis.It could involve the whole body's large and small joints,especially peripheral joints (often asymmetric),sacroiliac joint and spine.The course of PsA was protracted and easy to recur.Clinical and ima ging manifestations of PsA are similar to rheumatoid arthritis (RA),and need to identify diagnosis.The diagnosis and antidiastole in musculoskeletal ultrasound of PsA were reviewed in this article.

AIM: To establish nasopharyngeal carcinoma(NPC) cell lines stable expressing NPC-derived latent membrane protein 1(LMP1) gene. METHODS: General expression vector and epithelium-specific expression vector of NPC-derived LMP1 gene were constructed by using recombinant techniques, then transfected these vectors into a poor differentiated NPC cell line named CNE-2 ,integration and expression of N-LMP1 in CNE-2 cells were detected by PCR,RT-PCR and Western blot. RESULTS: (1) General expression vector and epithelium-specific expression vector of NPC-derived LMP1 gene were constructed successfully.(2) It showed that N-LMP1 gene expressed in CNE-2 cells correctly. CONCLUSION: The first NPC cell lines which stable express NPC-LMP1 were established. The cell lines obtained will provide important basis for exploring the role of NPC-LMP1 in nasopharynx carcinogenesis.

Objective To observe the effect of lnng-term in vitro culture on the biological properties of adipose-derived stem cells(ADSCs)as seeding cells of tissue engineering.Methods The surface makers and apoptosis of primary and passaged human ADSCs were identified by flow cytometric analysis.Osteogenic differentiation of ADSCs at different passages were identified by alkaline phosphatase(ALP),Von Kossa staining and RT-PCR respectively.Results The surface marker expression of mesenchymal stem cells on ADSCs was high and did not change with passages of the cells.The early apoptosis rate of the cells was 1% to 2%,and increased insignificantly from passage one to passage nine.The osteogenic potential of ADSCs confirmed by ALP,Von Kossa staining and RT-PCR was maintained to as late as passage eight.Conclusion Since the biological properties of ADSCs are stable,they can be served as optimal seeding cells for tissue engineering and regenerative research.

Objective To establish the data including anatomy and histology of main organs in Rongshui miniature pig (RMP).Methods F1 Rongshui miniature pigs with male and female (2 in each group) in 6 month old were used in this experiment.We measured body weights, dissected these pigs after anaesthesia, recorded total blood volume, total plasma volume, number of spine and dental formula, took main organs for photographs, and made histological sections observed and took photographs by microscope.Results We gained the photographs of main organs and histological sections, organ weights,organic coefficients and other basic data.Conclusion Basic anatomy and histology data of main organs in RMP were collected.